Self Mx chronic neck pain

I have a 60 yo patient at the moment who suffers from chronic neck pain and decreased ROM. She has global hypomobility of the Cx spine, tight suboccipitals, scalenes, UT and LS and bad posture. Previously she has had some improvement with Cx PAIVMs Rx along with STM and postural advice. She is currently doing a HEP consisting of gentle AROM, muscle stretches and some postural correction exercises (which she admits she does not do often). During her recent visit she reported that she was no longer getting much pain from the neck but instead the stiffness was more of an issue and she often found the muscles to be quite stiff and painful when she stretched them.

After SE and OE I was left to decide how to progress this patient. My first thought was that I neede to free up some of the PAIVMs with manual treatment but what level and direction would I do as there was global stiffness and pain throughout the whole Cx spine and the pain ws quite central. After talking to my supervisor about my findings and the long term goals of this patient I realised that although I could do some manual treatment today to free up a few of the restricted joints, in the long run, with the extent of arthritic changes within the neck, it would not be of any benefit. Therefore for this patient Rx was more outweighed by Mx for long term affect. Therefore this would include helping teach her to self massage tight muscles to both increase general AROM and help maintain a neutral posture, teach her appropriate stretches for all of the mm that were continually getting tight and most importantly educating her on the importance of a neutral posture and ongoing Mx.

The patient had not been putting as much emphasis on maintaining a neutral posture as she should have been due to both lack of knowledge and the inability to easily get into a neurtal position due to her tht suboccipitals. Therefore it was important to explain the pathophysiology behind her neck pain and how everything linked together. I then booked the patient in to be seen again the next week. I thought that this follow up was important to see if she was becoming affective in self Mx her condition, correct any errors th exercises and posture and reinforce withthe patient the importance of self Mx for the long term treatment of her neck problem.

The patient is yet not come back in at the moment so I do not have any follow up details. I would liek to know however if anyone has any other ideas as to self management techniques or any experiences in which they have had a similar patient, and the relative sucess rate for self Mx of this kind of condition?